MEDICARE: JOSE RICARDO DALPRAT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	20A11851	CA

General Provider Information

NPI Number	:	1013299627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE RICARDO DALPRAT D.O.

Provider Business Mailing Address
First Line	:	17861 TACOMA CIR
Second Line	:
City	:	VILLA PARK
State	:	CA
Zip	:	92861-6362
Country	:	US
Telephone Number	:	714-362-7548
Fax Number	:

Provider Business Practice Location Address
First Line	:	6025 N FIGUEROA ST STE B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90042-1365
Country	:	US
Telephone Number	:	323-507-2311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2011
Last Update Date	:	04/19/2018

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